July 02, 2007

Counselor and vet Mike Colson (left) and Vietnam vet
Ole Lindbo meet regularly over coffee.

by Joseph Shapiro, NPR

June 27, 2007
Iraq Vet Seeks Out the War's Hidden Wounded

All Things Considered, June 28, 2007 · The first Vet Centers were started almost 30 years ago by Vietnam veterans. The idea was that a veteran with a mental health problem will respond best to another veteran. Today, these storefront mental health clinics are trying to keep up with a new generation of soldiers returning from war.

The Vet Center in Seattle was one of the first to open, in 1979. It runs a therapy session every Tuesday called the Spirituality Group. Men sit in a circle with a Vet Center counselor and talk about how war hardened them and how they struggle now to find the good and joyous things in life.

Lynn Morlan was a 21-year-old Marine lieutenant, leading a platoon during the Tet Offensive in 1968.

"I was in country two days, and my platoon got hit in an ambush. I lost some men and some men wounded," Morlan tells the group. "I knew that day that I was not coming back from Vietnam alive. So I carried that through Vietnam and all of a sudden, miracles of miracles, I came back. I didn't get killed. And then I just continued to live my life that way… I know that death is just right around the corner, just ready to tap me right on the shoulder. So why plan? Why worry about a damn retirement?"

One young veteran in the group, Rob Densmore, sits at the edge of the circle. He flew jets in Afghanistan — the Navy's Prowler, a radar-jamming electronics warplane — but came home in 2004, when he developed life-stopping depression and PTSD.

"I was just unable to make even simple decisions, like if I was hungry or not, " Densmore says.

He's doing better today with help, including group sessions like this one. He prefers coming to the Vet Center because it's a small office suite, with only a half dozen staffers. At Seattle's Veterans Affairs hospital, he feels overwhelmed; it's so big and sprawling that the receptionist at the front desk gives visitors a map and marks their route. And it's hard for Densmore to see so many troubled older veterans, in the lobby and the halls, like ghosts of the future he fears most for himself.

"Just last week, I was at the VA and passed a guy walking down the hall who was a homeless amputee who lives, you know, on the streets below my apartment," Densmore says. "It's a very quick equation to this is who I am, this is my state, this is my lot, and it's not always a good picture that you see on the other side. I get good care at the VA. But you have to be tough sometimes to walk in there and see that."

Welcome Home

It's different at the informal Vet Centers. The first thing you see is a sign above the front door in bold letters that says, "Welcome Home." These signs are a tradition, started because the Vietnam veterans didn't feel welcomed back when they returned from war.

Most Vet Center clients are still Vietnam veterans. Only 17 percent are vets who have returned from Afghanistan and Iraq, but that number is growing. Ron Boxmeyer runs the Seattle Vet Center and says most of the mental health problems are the same — whether the war was Vietnam or Iraq. But there are differences.

"What is really bad about this war is that people are going back three and four times; we had one person who went back five times," Boxmeyer says. "At least in Vietnam, I knew after 12 months I could get the heck out of the Army and I'd never have to go back again. But these people they come home, they go back to work, and re-establish their families and then, bang, they're back again."

There are other differences with the new veterans. There are more women. And more veterans with traumatic brain injuries. These injuries often haven't been diagnosed, but are causing confusion and depression.

Getting Help

Mike Colson is a readjustment counselor at the Vet Center. He was a Navy chaplain in Iraq and Afghanistan, before coming home with his own PTSD. Now he tirelessly counsels troubled veterans and their families. A few Vietnam veterans have brought their sons, recently back from Iraq, into the Vet Center. But Colson also meets clients outside of the center. He regularly catches up with Ole Lindbo at a neighborhood cafe.

Lindbo served at the end of the Vietnam War. The back of his leather jacket reads, "U.S. Army Veteran," and he wears a camouflage skullcap over his long, gray braid. Over coffee, he tells Colson about what he calls "the incident." Several weeks ago, in the family garage, his son Eli, a soldier back from Iraq, started hallucinating that he was under attack.

"He kept saying, 'There's Iraqis around us, they're gonna shoot us. They're gonna shoot us,'" Lindbo says. "For all I know, I could have been an Iraqi to him, and that's why I didn't want to let go of him." Lindbo held onto his son as tightly as he could, as Eli flailed about, lost in a violent flashback.

Therapists at the VA hospital can counsel a veteran. Vet Center therapists can treat their family, too.

Colson helped Eli get immediate treatment at the VA hospital. Since then, Colson and Lindbo meet regularly over coffee.

Last year, a congressional report — and a report from the VA — showed some Vet Centers were struggling to help all the veterans home from Afghanistan and Iraq. Earlier this year, Congress gave funding to open 23 new Vet Centers and hire more staff at the existing 209 centers. But the need keeps growing. More than 1.5 million troops have served in Afghanistan and Iraq, and at least one out of six come home with a potentially serious mental health condition. So far, 51,000 have gone for counseling at a Vet Center.

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Colson refers to himself as the "dog catcher for trauma."
His job is to get traumatized veterans into care before it's too late.

By Joseph Shapiro

All Things Considered, June 27, 2007 · Many troops returning from Afghanistan and Iraq will struggle with depression and post-traumatic stress disorder. Some will drink too much and use drugs. They'll lose jobs. They'll drive away friends, family, spouses and children. Most of them won't ask for help.

Mike Colson is a mental health counselor for the Department of Veteran's Affairs in Washington state. He believes that with the right medications and counseling, these veterans can learn to live and function while dealing with the mental health problems common to war. His job is to get traumatized veterans into care before it's too late. He jokingly refers to himself as the "dog catcher for trauma."

Colson drives his government-issued car hundreds of miles a day, from military base to military base. He tells scores of men and women just how hard it's likely to be — mentally and emotionally — to go back to civilian life when they have just come from the brutal chaos of war.

At a Navy base near Seattle, 60 sailors and Marines wait inside an auditorium. Before leaving the military, they have to sit through three days of departure briefings filled with information. They're already slumped in their chairs when Colson enters the auditorium, walking with a shadow of a limp. A tough-looking guy, with a shaved head and a dark suit, Colson knows he has one chance to reach the young men and women in the room. He might even save somebody's life.

"To be a warrior, is to be exceptional," Colson tells the group. "But it can come at an emotional cost."

Colson knows there is a stigma attached to asking for help in the military. So he knows he can't use the words "mental illness" or "post-traumatic stress disorder" until he tells them something about himself: He has PTSD.

"Do I look like I have post-traumatic stress?" he says. "Just look at me. What do you think? Why am I able to talk to you? Medicine. That's right, I take it every day. Am I a better person because of it? Yeah. Will I be better next month? I don't know. But I'm better today."

War Experiences Come Home

The Navy sent Colson to Afghanistan twice and Iraq twice as a chaplain. He counseled soldiers who had seen friends die and who struggled with their own nightmares. Colson himself was severely injured in a helicopter crash several years ago. He broke his back and had eight surgeries. When he came home, he was anxious and distant. He put carpet down in his garage and slept there, alone, at night. He was slow to see that these were signs of his own PTSD.

One day, a Navy psychiatrist noticed Colson's "thousand-mile stare" — the distracted and distant gaze that marks those dealing with PTSD.

"He saw it in my face," Colson recalls. "He read trauma like a book… And he saved me. And he medicated me. He took the anger away, he got me to sleep for the first time in a few years."

Now, when he helps others, he is also helping himself heal. But Colson knows recovery is fragile, for himself or anyone with PTSD. And he knows that no matter how many thousands of troops hear him speak, no matter how many he gives his e-mail and phone number to, there will be some he won't reach in time. It has happened in his own family, to his nephew, a Marine who returned home from Fallujah.

His nephew lived far away. Colson called, wrote and even made therapy appointments, but they went ignored. His nephew drank and withdrew. One night, alone in his father's house, his nephew shot himself and died.

In some ways, Colson feels responsible for his death.

"I was a suicide-prevention officer for the Navy, for God's sake," he says. "Let's be honest. I didn't save him. I failed. And that failure will haunt me. When I talk to my sister, it's there. When I walk into a family gathering, it's there."

Stigma Can Cost Lives

He thinks the bravado of military service prevented his nephew from seeking help. He says that in the military, "Readjustment issues, and concerns, and PTSD and that horrible word, you know, mental illness, that's something you never tell anyone and that stigma can cost people their lives."

At another Navy base, Colson gives his speech again. He hopes he will shock more sailors and Marines into getting care. As he speaks, he scans the young faces in the room. He sees a woman with a girlish face in the third row who is blinking back tears. He watches two men who don't laugh at his jokes, but he sees that they're listening — closely. As Colson packs up, the woman in tears and the two men who didn't laugh seek him out privately. Colson will get them appointments at the Vet Center and hope they show up.

When Colson gets to his office the next day, there are four more e-mails from others. It's a handful. But for Mike Colson, it's a start.

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After four tours in Afghanistan and Iraq, and having paid the price with significant disabilities, I retired and began working as a trauma and outreach specialist with the Veteran’s Administration. That said, it was obvious that if I were going to visit wounded warriors, I would need help. Enter Quilts of Valor (qovf.org).

When I asked QOV responded. From seeming every corner of the United States, I received quilts from wonderful people that I began taking with me as I visited wounded and traumatized veterans across the great State of Washington. It hurts to admit that I actually became quite attached to these blanket-sized works of art. The mostly men, and some women, who received these in their hospital room and homes were overjoyed – speechless even. On subsequent visits the recipients would invariably ask if others they knew could get a similar blanket. QOV never let them down.

On one occasion, the blanket itself taught me a great lesson. As a provider and clinician, I move through medical facilities constantly. I take into account the standard rules of engagement and, though friendly and engaging, try and keep some distance. On this day my patient was confined to his bed, legs akimbo in stirrups, and bandaged from feet to hips. He had been crushed when two M1A1 tanks crushed the Humvee he was in when executing a failed two-sided pass. The outside of his leg was virtually stripped of flesh. Enter Dr Mike and his quilt.

As I stood talking and commiserating with my charge, the Army sergeant’s dear wife and baby entered. With quilt in hand I attempted to leave the right side of his bed, move to his left, and thereby give the family some room. At the end of the bed I managed to drop the quilt just low enough to catch the stainless steel rod exiting directly out of where his left toe should have been. That’s right; I hooked with the quilt a steel rod sticking out from a man in traction’s toe…with immediate effect! He howled. I howled. The baby started crying and his wife thought we were being filmed for a bad reality show.

The result was two-fold. One, he got his QOV blanket for which they were very thankful. Two, I learned that I needed to get much better at my job fast! The entire family agreed.

To date, I see nearly four hundred soldiers and other military personnel a week conducting trauma outreach for the Seattle, Washington and other Vet Centers. And since that little incident I have not impaled one single quilt loop on a patient or on any of the medical apparatus. So, I am better. But I am not nearly as good as the QOV quilters and staff. I do, though have one piece of advice for QOV’s volunteer; Keep those loops small!

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